Case Of Small Bowel Obstruction Research Articles

Anti-Hyperglycemic Medication Management in the Perioperative Setting: A Review and Illustrative Case of an Adverse Effect of GLP-1 Receptor Agonist

A host of anti-hyperglycemic agents are currently available and widely prescribed for diabetes and weight loss management. In patients undergoing surgery, use of these agents poses a clinical challenge to surgeons, anesthesiologists, and other perioperative care providers with regard to optimal timing of discontinuation and resumption of use, as well as possible effects of these agents on physiology and risk of postoperative complications. Here, we provide a comprehensive review of anti-hyperglycemic medications’ effects on physiology, risks/benefits, and best practice management in the perioperative setting. Additionally, we report an illustrative case of small bowel obstruction in a patient taking semaglutide for 6 months prior to an otherwise uncomplicated laparoscopic hysterectomy and bilateral salpingo-oophorectomy. This review is meant to serve not as a replacement of, but rather as a consolidated complement to, various society guidelines regarding perioperative anti-hyperglycemic agent management.

An unusual case of small-bowel obstruction: Broad ligament hernia.

Broad ligament hernias (BLHs) are rare internal hernias that can lead to serious complications if left untreated. In this case report, we present the case of a BLH in a female patient and discuss its clinical presentation, diagnosis and management. A 40-year-old woman presented with subacute intestinal obstruction symptoms, including the inability to pass flatus and faeces and recurrent bilious vomiting. A computed tomography (CT) scan confirmed small-bowel obstruction adjacent to the uterus within the left broad ligament. Diagnostic laparoscopy revealed a loop of obstructed small intestine within the broad ligament, which was released and found to be healthy. The defect between the broad and infundibulopelvic ligaments was closed with sutures. The patient had an uneventful recovery and was asymptomatic at a 6-month follow-up. BLHs can be congenital or acquired, with acquired defects often resulting from previous surgeries or pregnancy-related causes. The clinical presentation typically involves the symptoms of bowel obstruction, and a CT scan is the diagnostic modality of choice, showing characteristic findings such as closed-loop obstruction and bowel dilation. Laparoscopic management offers the advantages of faster recovery and less morbidity. Closure of the defect using nonabsorbable sutures is the standard surgical approach, although a wide opening of the defect has also been described. Recurrence is a possibility, particularly if absorbable sutures are used for closure. This case report highlights the importance of early diagnosis and intervention in BLHs to prevent the complications and emphasises the role of laparoscopy in their management.

Unusual causes of Small bowel obstruction: a review of the literature and revisited cross-sectional imaging checklist.

Intestinal obstruction is a common surgical emergency with high morbidity and mortality. Patients presenting with features of small bowel obstruction need urgent evaluation to avoid complications such as bowel gangrene, perforation, or peritonitis. Imaging is necessary in most cases of suspected bowel obstruction, to take an appropriate decision, for apt patient management. Among the common causes of small bowel obstruction, adhesions, external herniae, malignancies, and Crohn's disease top the chart. Imaging helps in determining the presence of obstruction, the severity of obstruction, transition point, cause of obstruction, and associated complications such as strangulation, bowel gangrene, and peritonitis. This review is based on the cases with unusual causes of bowel obstruction encountered during our routine practice and also on the extensive literature search through the standard textbooks and electronic databases. Through this review we want our readers to have sound knowledge of the imaging characteristics of the uncommon yet important causes of bowel obstruction. We have also revisited and structured a checklist to simplify the approach while reporting a suspected case of small bowel obstruction. Imaging plays a key role in the diagnosis of small bowel obstruction and in determining the cause and associated complications. Apart from the common causes of small bowel obstruction, we should also be aware of the uncommon causes of small bowel obstruction and their imaging characteristics to make an accurate diagnosis and for apt patient management.

The impact of transanal drainage tube on the incidence of anastomotic leakage and small bowel obstruction in radical surgery (Dixon) for rectal cancer: a retrospective cohort study.

Anastomotic leakage (AL) and small bowel obstruction (SBO) are common complications after rectal cancer radical surgery (Dixon). Although the commonly used defunctioning stoma (DS) can reduce the incidence and harm of AL, it increases the probability of other adverse consequences, including SBO. Therefore, a safe and effective method for preventing the complications related to the radical surgery of rectal cancer is urgently needed. Previous studies have found that transanal drainage tube (TDT) can have a positive impact on the incidence of these two complications by draining gas and feces from the intestinal lumen, without causing other serious consequences. Therefore, this article further explores the clinical benefits that TDT can bring by analyzing the clinical data of postoperative patients with rectal cancer. This study included 221 patients who underwent radical surgery (Dixon) for rectal cancer in Hubei Cancer Hospital from September 2020 to February 2023, determine whether it meets the inclusion criteria of this study based on preoperative examination, intraoperative exploration results, and treatment methods. DS was used in 70 patients and TDT in 88 patients during the surgery; meanwhile, no protective anastomotic measures were applied in 63 patients. Seventy patients subjected to DS were categorized as group 1, 88 patients subjected to TDT as group 2, and 63 patients with no protective measures for anastomosis as group 3. Through postoperative clinical manifestations, imaging examinations, and laboratory tests, a total of 18 cases of AL and 30 cases of SBO were identified in the three groups. The effectiveness of TDT and that of other surgical procedures in preventing complications, accelerating postoperative recovery, and reducing surgical costs were compared through univariate and multivariate analyses. The clinical features of the three groups have baseline comparability. No statistically difference was noted in baseline characteristics between three groups (all P>0.05). The incidence of AL and SBO in group 1 are 7.1% and 27.1%, in group 2 are 3.4% and 4.5%, and in group 3 are 15.9% and 11.1%. Compared to patients in no protective anastomotic measures with TDT and DS, TDT has a lower incidence of postoperative AL (P<0.05) and SBO (P>0.05), and faster postoperative recovery (P<0.05). The cost of inpatient surgery is not significantly different (P>0.05). Although DS can reduce the incidence of AL to a certain extent (P>0.05), it significantly increased the incidence of SBO (P<0.05), delayed postoperative defecation time (P<0.05) and caused higher cost (P<0.001). Compared to DS, the incidence of AL in TDT is not significantly different (P>0.05), but the incidence of SBO is noticeably lower (P<0.001), with faster postoperative recovery and less cost (P<0.05). TDT is a safer, more effective, and more economical surgery for preventing postoperative complications.

Abdominal Cocoon: a rare case of small bowel obstruction, a case report

Sclerosing encapsulating peritonitis (SEP), or abdominal cocoon syndrome (ACS), is an uncommon disorder marked by a thick fibrotic membrane that completely or partially envelops the small bowel. For surgeons, preoperative diagnosis is difficult and challenging. The majority of documented, diagnosis were made during a laparotomy. We present a case of SEP that was diagnosed preoperatively. The patient had a complete small bowel obstruction that necessitated urgent surgery. We review the literature and discuss the causes, clinical manifestation, and management of the condition.

Beyond Cardiology: A Rare Encounter With Small Bowel Obstruction Disguised as Inferior Wall ST-Elevation Myocardial Infarction

ABSTRACT ST segment elevations (STEs) on an electrocardiogram (EKG) gravitate immediate attention to the heart. However, these EKG changes can sometimes be the result of noncardiac pathologies. Here, we present an interesting case of small bowel obstruction (SBO) masquerading as an inferior wall myocardial infarction. A 77-year-old woman with a history of aortic stenosis status postsurgical aortic valve replacement presented with chest pain. Workup revealed elevated high-sensitivity troponins and STE in the inferior leads. She subsequently underwent a left heart catheterization, which showed no critical plaques or stenosis. Persistent abdominal pain prompted further evaluation with a computed tomography scan of the abdomen, which demonstrated evidence of SBO. Conservative treatment with bowel decompression resulted in symptom improvement and complete resolution of the STEs on a follow-up EKG. This case underscores the importance of considering noncardiac etiologies, such as SBO, in the differential diagnosis of STE on EKG for accurate diagnosis and management.

Diagnostic accuracy of computed tomography scan against surgical findings in small bowel obstruction cases

Diagnostic accuracy of computed tomography scan against surgical findings in small bowel obstruction cases

"Bezoar Egg"-A Rare Cause of Small Bowel Obstruction.

Small bowel obstruction is a frequent medical condition with various causes, the most common being postoperative adhesions, volvulus, intussusception, hernias, and tumors. A bezoar-induced blockage of the small intestine is a rare condition that accounts for approximately 4% of all small bowel obstruction cases. Herein, we present the case report of a 71-year-old patient with diffuse abdominal pain caused by a small bowel obstruction due to a calcified bezoar (bezoar egg) resulting from a post-radiation intestinal stricture. The patient underwent a small bowel excision with the extraction of the bezoar, after which a full recovery was made.

Adhesion Band Small Bowel Obstruction in Virgin Abdomen: A Case Report

Small bowel obstruction (SBO) is a common surgical emergency, accounting for almost 50% of all emergency laparotomies with significant in-hospital morbidity. History of previous intra-abdominal surgery is very common in SBO patients, which can include up to 80% of these patients. However, there are cases of SBO with no prior abdominal surgery caused by omental bands, which are very rare and have a high probability of misdiagnosis, referred to as a virgin abdomen. In this article, a rare case of adhesion band small bowel obstruction in a virgin abdomen is presented. Although the factors related to SBO in a virgin abdomen and its underlying causes are not yet fully understood. In this case, the most possible explanation is considering the patient’s age and congenital condition because of the absence of previous abdominal surgeries or inflammation history.

OGC P67 Extended Use of Feeding Jejunostomy and Reduction of Weight Loss in Patients with Total Gastrectomy for Malignancy

Abstract Background Malnutrition and weight-loss are correlated with higher mortality and morbidity in patients undergoing total gastrectomy(TG) for gastric cancers. The role of feeding jejunostomy(FJ) in the event of leak and extended use for postoperative nutritional support is much debated. There is a variation of practice in insertion, duration and monitoring of FJ and the evidence is sparse.This study presents the experience of a tertiary referral centre where the use of FJ is extended after TG with intention of delivery of home enteral tube feeding(HETF); its effect in reduced percentage weight-loss during post-operative and adjuvant chemotherapy period were evaluated. Methods A retrospective cohort study of patients who underwent total gastrectomy for gastric adenocarcinoma between January 2017 to June 2022 at a tertiary referral centre were included. Length of stay, post operative complications and complications associated with feeding jejunostomy insertion were assessed along with adjuvant chemotherapy data and percentage weight loss 12 months following TG. SPSS software was used with frequencies analysed by chi squared test and continuous variables by T test. All p values were two tailed and values less than 0.05 were considered significant. Results 82 patients who underwent TG were included; 37 had FJ inserted and 45 patients did not. Of the 37 FJ patients, 34 were discharged with HETF. Median duration of HETF was 127 days(56-428). HETF patients had a significantly reduced percentage weight-loss at 1-, 3- and 6-months post-TG. At 12-months, although reduced percentage of weight-loss in FJ group was observed, this was not statistically significant. Adherence and completion rate of adjuvant chemotherapy was higher in FJ group.There was no difference in length of stay and post-operative complications.11 FJ-related minor complications were reported.1 case of small bowel obstruction was managed conservatively. Conclusions The use of FJ with HETF post TG was safe, posing minimal complications. There is a significant reduction in percentage of weight loss in the first 6 months in the FJ group. This may indicate improved nutritional status and therefore better adherence and completion of adjuvant chemotherapy observed. The role of FJ spans beyond nutritional support in the event of anastomotic leak; extended use during adjuvant therapy period should be considered. Large scale controlled studies are required to further evaluate the benefits and cost-effectiveness.

Ileoileal Intussusception Secondary to Meckel's Diverticulum: A Case Report

Background: The most frequently documented aetiology of Meckel's related obstructions is volvulus or intussusception of the small bowel with the presence of Meckel's diverticulum as the lead point. This study presents a case of small bowel obstruction caused by intussusception due to Meckel's diverticulum, which led to an obstruction of the small intestine.&#x0D; Case presentation: A 17-year-old male patient visited the hospital's emergency room complaining of worsening abdomen pain for two days. It was associated with abdominal distention, fever, nausea, and vomiting. There was no roving's sign or psoas sign and no rebound tenderness. There is no history of gastrointestinal cancer in his family or previous abdominal surgery. The white blood cell count was 18,400 c/mm, and the electrolytes, liver function tests (LFTs), and urinalysis were all within normal ranges. Ultrasonography imaging of right lower quadrant (RLQ): thickening tubular structure with target sign view and enteric intussusception with the possibility of appendix component.&#x0D; Conclusion: A 17-year-old male went to the emergency room complaining of acute abdominal pain and was diagnosed with ileoileal intussusception intraoperatively.

FRI643 Tirzepatide Associated Partial Small Bowel Obstruction: A Case Report

Abstract Disclosure: A. Mathew: None. H. Hannoodee: None. Glucagon-like peptide-1 receptor agonists (GLP1 RA) are quickly becoming an adjunctive treatment modality for people with type-2 diabetes and is approved for chronic weight management. Tirzepatide has a dual GIP/GLP-1 RA action and has a synergistic effect when administered together. GLP-1 RA are associated with improved cardiovascular and all-cause mortality outcomes in patients with type-2 diabetes. Tirzepatide is associated with gastrointestinal (GI) side effects like nausea, diarrhea, abdominal pain, decreased appetite, and constipation. This case report discusses a case of small bowel obstruction (SBO) that was noted after patient was changed from dulaglutide to tirzepatide. Mr. X is a 61 y/o male with PMHx of type-2 DM, HTN, and HLD who presented to ER for severe epigastric pressure- like 7/10 abdominal pain. No association with food intake. He had 1 episode of semi-loose stools. Denied any abdomen cramping, sick contacts, nausea/vomiting, fever/chills, or constipation. His previous endoscopy was only relevant for benign colonic polyps, which were removed. He had been on GLP1 RA for more than a year, and previously on dulaglutide 3mg, which was switched to tirzepatide 2.5mg 5 weeks ago. He was able to tolerate the medication without significant side effects and was recently up-titrated to 5 mg. Labs showed WBC 7.2, Hb 13.6, Cr 1.45, BUN 12, lipase 25, and normal LFTs. Abdominal X-ray and CT abdomen were noted to be significant for a partial vs evolving SBO without any identifiable small bowel intrinsic pathology. Mr. X was managed conservatively with fluids, NPO diet, and pain medications. Serial abdominal images were obtained, and he was eventually advanced to soft diet. Tirzepatide was discontinued on discharge. As a response to enteral nutrition, distal small bowel and colon release GLP-1 hormone. Exogenous and endogenous GLP-1 are associated with reduced gastric motility. GLP 1 RA and dual GIP/GLP-1 RA are advised to be used with caution in patients with established gastroparesis, as they can worsen the symptoms. GLP-1 effect on small intestinal motility is not extensively studied, however, small bowel motility inhibition was noted in animal models. Some of these actions were dose-dependent. There are some case reports of SBO due to GLP-1 RA. An observational cohort study noted an increased incidence of SBO with GLP1 RA when compared to SGLT2i. They noted most incidents of SBO happened early within the initiation of therapy (within 3 months). At the time of writing this abstract, there are no published SBO case reports associated with tirzepatide. Further large-scale clinical trials need to be conducted to explore the association of SBO in patients with GIP/GLP-1 and GLP-1 RA. These studies will help guide if these drugs should be contraindicated or used with caution in people with a previous history of SBO or colonic obstruction. Presentation: Friday, June 16, 2023

1309 A Quality Improvement Project on Small Bowel Obstruction Operative Mortality Rate

Abstract Aim Higher than average emergency laparotomy mortality rates had been identified via the National Emergency Laparotomy Audit (NELA), at a particular hospital. Small bowel obstruction (SBO) is the commonest cause for emergency laparotomy. The aim of this project was to evaluate the management of SBO, and to implement changes to reduce the operative SBO mortality rate. Method NELA was used to assess emergency laparotomy cases between 1st Dec 2018 - 30th Nov 2019; (n = 198), of which there were 24 mortalities. The dataset was filtered for SBO (n = 87), of which there were 12 mortalities. The clinical management of these 12 SBO mortality cases were analysed and compared to the latest ASGBI and NCEPOD recommendations on SBO management. Following this review, a systematic change in the management of SBO was introduced with the aim of reducing time to operation, appropriate candidate selection and avoiding drifting in management. This consisted of producing a SBO management flowchart as well as ensuring allocation of theatre slot within 72 hours for patients suitable for operation. Results Following the intervention, we assessed cases between 1st April 2021 - 31st March 2022 (n = 152), of which there were 13 mortalities. The dataset was filtered for SBO cases (n = 57), of which there were 3 mortalities. Emergency laparotomy mortality rate reduced from 12% to 9%. SBO operative mortality rate reduced from 14% to 5%. Emergency laparotomy deaths relating to SBO reduced from 50% to 23%. Conclusions The intervention resulted in improvement in SBO operative mortality rates as well as overall emergency laparotomy mortality rates.

Spectrum of Clinical Presentations and Surgical Management of Tuberculous Small Intestinal Obstruction

Background: The causes of acute Intestinal Obstruction vary demographically. In the developing world, tuberculosis account for more than half of all cases of small bowel obstruction. Tuberculosis is a major health burden in developing countries. It can result some medical as well as surgical emergencies. Among the surgical emergencies, small gut obstruction is the burning issue. It can show wide spectrum of presentations. Objective: To find out spectrum of clinical presentations and surgical management of tuberculous small intestinal obstruction. Methods: It was a cross- sectional study conducted in the Department of Surgery, Sher-E-Bangla Medical College Hospital from July 2015 to December 2015. A total of 100 patients were selected by purposive sampling methods. The detail history and clinical examination findings were recorded including patient’s demographic profile and clinical as well as investigation findings. Preoperative findings and post-operative complications were also observed and recorded. Results: According to the result analysis, maximum patients were young adult and the highest patients (54%) came from 21-30 year’s age group followed by 31-40 year’s age group (18%). Among the respondents, 62% were male and 38% were female patients. The male to female ratio was 1.63:1. The results of clinical presentations revealed that all (100%) patients presented with abdominal pain followed by abdominal distension (78%) as small gut obstruction was mostly prevalent. Besides, constitutional features like weight loss and low grade and evening rise of temperature were present in almost all tuberculous patients. Operative findings revealed that single/multiple small bowel stricture in 80% patients followed by bands and adhesion in 14% patients. Strictures as well as perforation were present in case of 11% patients. Maximum operative procedures performed right hemicolectomy with ileo- transverse anastomosis (58%) followed by segmental bowel resection with end ........

An unusual case of small bowel obstruction because of body packing

Body packing is the internal concealment of illicit drugs for the purpose of transportation and evasion of law enforcement. It is associated with medical complications such as acute toxicity from ingested drug, bowel obstruction or perforation. It is rare to require surgical intervention with a small amount of ingested drug packet. Here, we present the case of a young adult male who presented with abdominal pain for 3days. The patient admitted ingesting a condom filled with suboxone several years ago and denied recent ingestion. The patient was found to have small bowel obstruction with ingested foreign body being a transition point on CT scan, requiring exploratory laparotomy and small bowel resection.

A CASE REPORT: SMALL BOWEL OBSTRUCTION DUE TO OBTURATOR HERNIA

Introduction: The obturator hernia is an uncommon cause for small bowel obstruction. It is classically described in thin elderly women. Delay to diagnosis may result in strangulation and gangrenous bowel at subsequent laparotomy The classically described signs, whilst useful when present, are absent in greater than 50% of cases, and preoperative diagnosis is made on radiological imaging. A 79-year-old female presented Case report: to hospital with a 2 – days history of vomiting, generalized dull aching abdominal pain and enable to pass stool for 2 days. Past medical history included scoliotic deformity in lumbar spine and previously operated for tubal ligation before 32 years. Laparotomy, bowel resection and suture hernia repair were undertaken. A subsequent presentation of small bowel obstruction was due to recurrence of the obturator hernia. However, resolved without operative management. A very high index of suspicion is required when Discussion: presented with the case of small bowel obstruction in an elderly female patient. One must therefore, also consider that any subsequent presentations of small bowel obstruction may be due to recurrence of the obturator hernia, the differential being adhesive bowel obstruction, and delay to denitive treatment is associated with poorer prognosis. A high index of suspicion is required to diagnose an obturator hernia clinicall Conclusion: y. Failure to do so results in greater mortality and morbidity. Early cross-sectional imaging can make the diagnosis and lead to earlier surgical repair. A diagnostic challenge, an obturator hernia is a rare cause of small bowel obstruction. Delay in diagnosis is associated with adverse outcome. Computed tomography scan has proved invaluable to early detection and repair.

Ileocolic intussusception in an adult secondary to ileal lipoma – case report

Intussusception is a common surgical presentation in paediatrics, however it is rare in adults. It is reported to be the cause of as few as 1% of small bowel obstruction cases in adults.1 Unlike the majority of paediatric presentations which tend to be idiopathic, almost all adult cases are secondary to pathological lesions.2,3 We present a case of ileocolic intussusception in a 32-year-old male with no significant past medical history. CT abdomen and pelvis showed distal small bowel obstruction due to the intussusception, with a lipoma appearing as the lead point.

A Case of Small Bowel Obstruction Caused by Gastrolithiasis after Pylorus-preserving Gastrectomy Treated by Single-port Laparoscopic Surgery

A Case of Small Bowel Obstruction Caused by Gastrolithiasis after Pylorus-preserving Gastrectomy Treated by Single-port Laparoscopic Surgery

S3380 Atherosclerotic Small Bowel Ischemia Causing Intestinal Obstruction and Volvulus

Introduction: Obstructions are the most common events requiring surgical intervention in the small intestine. Several factors can cause an obstruction, with adhesions from previous surgeries being most common. It is rare for the obstruction to be caused by volvulus of the small bowel, and increasingly more rare for that volvulus to be caused by ischemia due to atherosclerosis. Presented herein is a unique case of small bowel obstruction due to volvulus of the small bowel that resulted from severe bowel ischemia. Case Description/Methods: The case discusses the medical and surgical management of a 70-year-old man who presented to the emergency department with abdominal pain. After a thorough history, physical exam, and diagnostic testing, the patient was diagnosed with small bowel obstruction due to volvulus, secondary to atherosclerotic ischemia of the small intestine, and rushed to surgery. After the surgical intervention and hospital stay, the patient made a complete recovery and was asymptomatic at follow-up appointments. Discussion: Small bowel obstructions occur mostly due to adhesions from prior surgeries. It is exceedingly rare that they may occur due to volvulus. This case is unique in that the inciting event was significant small bowel ischemia, likely from uncontrolled hyperlipidemia and atherosclerosis as evidenced by the CT findings of a severely atherosclerotic abdominal aorta. The ischemia then made way for the necrotic segment of the small bowel to twist upon its mesentery and cause a closed loop obstruction and further compromise of the blood supply to the small intestine. The presentation of a volvulus in the small intestine is not as easily recognizable on radiographs as a sigmoid and cecal volvulus. The classic “birds beak” phenomenon characteristic of any volvulus on contrast enhanced plain film was not seen in this case. Imaging was consistent with a small bowel obstruction, but the etiology was unclear until an exploratory laparotomy was performed. It is likely that this patient had a chronic underlying process of mesenteric ischemia before presenting with this volvulus that was never diagnosed. Ischemia must be considered as a differential or possibly as an underlying factor for future management when working up a patient for bowel obstruction. Swift intervention in this scenario likely prevented outcomes such as perforation and severe hemodynamic instability. This patient would benefit from cholesterol lowering medications and possibly endovascular repair to prevent future recurrence.

Diagnostic Accuracy of Ultrasound for Small Bowel Obstruction in Paediatric Population Undergoing Laparotomy Keeping Surgical Findings as the Gold Standard

Objective: To analyze the diagnostic accuracy of ultrasound in small bowel obstruction in the paediatric population and compare it with surgical findings.&#x0D; Study Design: Cross-sectional study.&#x0D; Place and Duration of Study: Radiology Department, Pakistan Institute of Medical Sciences, Islamabad Pakistan from Jun 2018 to Jun 2019.&#x0D; Methodology: This study enrolled 84 paediatric small bowel obstruction cases who underwent exploratory laparotomy at the Pakistan institute of medical sciences from Jun 2018 to Jun 2019. The clinically suspected cases of small bowel obstruction were referred by paediatric surgery to the Radiology department, where an ultrasound abdomen was performed by a senior resident, exclusively targeting the bowel. The clinical, sonological, and per-operative findings were recorded on a proforma.&#x0D; Results: The mean age in our study was 3.5±2.7 years. A male gender predominance was noted. The most consistent greyscale feature favouring bowel obstruction was dilated bowel loops, found among 98.7% (76 out of 77) of surgically confirmed cases of bowel obstruction. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of ultrasound were 98.7%, 71.4%, 97.4%, 83.4% and 94.6% respectively. The sonological cause of obstruction was readily demonstrated among 51 (67%) out of 76 true positive cases. The most common site of obstruction was the distal ileum, with intussusception being the leading cause found among 32% of true positive cases.&#x0D; Conclusion: The overall diagnostic accuracy of ultrasound in revealing small bowel obstruction is high among the paediatric population.